Value of SpyGlass direct visualization system combined with tumor biomaker in the diagnosis of maglinant bile duct stricture

Objective: To explore the value of SpyGlass direct visualization system(SpyGlass)combined with tumor biomakers carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP)and carbohydrate antigen 125 (CA125) in the diagnosis of maglinant bile duct stricture .Methods: The clinical data of nineteen cases of patients with bile duct stricture admitted to The First Affiliated Hospital of Guangxi Medical University from August 2020 to July 2022 were retrospectively analyzed, and underwent SpyGlass test as well as serum tumor marker detection.The value of SpyGlass and serum tumor markers in the diagnosis of malignant bile duct stricture was analyzed by receiver operating characteristic (ROC) curve.Results: Among the nineteen cases of bile duct stricture, there were ten benign cases and nine malignant cases.The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under ROC curve (AUC) of Spy-Glass in the diagnosis of malignant bile duct stricture were 88.9%, 80.0%, 80.0%, 88.9%, 84.2%, and 0.826, respectively.Meanwhile, the sensitivity and specificity of serum CA19-9 in the diagnosis of malignant bile duct stricture were 100.0% and 70.0%, respectively; AUC was 0.889, higher than that of AFP 0.625, CEA 0.694 and CA125 0.764.When SpyGlass was combined with CA19-9 detection, both the sensitivity of parallel method and the specificity of series method were 100.0%.Conclusion: SpyGlass combined with serum CA19-9 can improve the diagnostic value of malignant bile duct stricture.